South East Pump Tournament Registration form

Please identify and describe your team:

Team Name
Captain Age	player 2: Player 3: alt 1: alt 2:

New team    Novice Team Experienced Team

First Pump tournament:  yes No

           Please provide the following contact information:

Team Captains Name
Team Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
AGE
E-mail
URL

Please provide the following registration information:

Team members information:

   

Player  Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
AGE
E-mail

Player  Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
AGE
E-mail

Alternates (not required for event, but if used, information must be provided.)

Player  Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
AGE
E-mail

Player  Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
AGE
E-mail

 

paypal money order ceritifed check Payment type    A payment request will be sent to the team captains email address upon receipt of this electronically submitted form.  No slots will be reserved until payment in full is received. Payment may be made via Paypal™ (Credit cards accepted), US Postal Service Money Order  (Sorry, no "convenience store" m/o's ) or bank certified check. A mailing address will forwarded to you for non electronic transactions.

Enter the date of tournament registering for :

Comment or questions here:

 

I have read the RULE BOOK, the WAIVER OF LIABILITY, and agree to the terms of this event as set fourth above. By submitting payment to participate in this event, I further attest that I and my team mates as entered above, understand the terms, conditions, and inherent risks involved in paintball as it pertains to this event.